title: Sleep apnea, heart failure, and pulmonary hypertension.
abstract: Despite the emergence of sleep apnea (SA) as a significant risk factor for heart failure (HF) mortality, data indicate that SA remains under-diagnosed and under-treated. Less well established, though perhaps more emphasized, is the role of sleep apnea in pulmonary hypertension (PH). SA occurs in approximately 50 % of HF patients, and its consequences include intermittent hypoxemia, arousal, and intra-thoracic pressure swings leading to neurohormonal stimulation, oxidative stress and inflammation. While SA is also considered a cause of PH, severe PH due solely to SA is rare. Combining the results of several studies using Swan-Ganz catheters for diagnosis of PH, approximately 10 % of patients with OSA have PH. Effective treatment of SA in HF is associated with improved survival, while treatment of SA in PH is typically associated with modest hemodynamic improvement.
authors.affiliation: Brigham and Women Hospital, Harvard Medical School, Boston, MA, USA, sjavaheri@partners.org.
authors.forename: Sogol
authors.initials: S
authors.lastname: Javaheri
authors.forename: Shahrokh
authors.initials: S
authors.lastname: Javaheri
authors.forename: Ali
authors.initials: A
authors.lastname: Javaheri
mesh_terms: D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D013318:Stroke Volume / Q000502:physiology